Medical Microbiology Lecture Notes PDF

Topics, *Additional Notes, Examples Medical Microbiology 08/02/24 **additional notes: integrate sarili nila sa bacterial - Diseases where the etiologic agents are classified as chromosome w/c will change the phenotype of microb...

Topics, *Additional Notes, Examples Medical Microbiology 08/02/24 **additional notes: integrate sarili nila sa bacterial - Diseases where the etiologic agents are classified as chromosome w/c will change the phenotype of microbes bacteria. kunware sensitive siya sa antibio, magiging Characteristics resistance** - Too small to be seen by the naked eye Microscopic Infectious Agents Streptococcus pneumoniae Bacteria Bacterial Transformation by Frederick Griffith’s Viruses Experiment **one of the landmark exp. In mol bio** Fungi Two variants: S form and R form Parasites S form: Smooth colonies because it is encapsulate Protozoans e.g., amoebiasis - Highly virulent, because capsule is a vital Zoonotic Infections virulent factor Rabies - Causes the deadly lobar pneumonia Bacillus anthracis (sheep) R form: Rough colonies because non-encapsulated Toxoplasma (cats) Consideration: Plasmodium (mosquitos) Presence of virulence factors - mediated by Trypanosoma (flies) bacteriophage **considered as Brucella - important zoonotic infection from milk MGE** causing brucellosis Microbial/Bacterial load - minimum number to induce pathogenicity Domains: Eukarya, Bacteria, Archaea Corynebacterium diphtheria Both Archaea and Bacteria are unicellular simple Gram positive bacilli microbial agents *difference: prokaryote ang Causes diphtheria bacteria* Two types: Pathogenic and non pathogenic Archaea Diphtheroids - gram positive diphtheria-like bacteria Archaea are notable for their resistance (highly) in Deadly when mediated by bacteriophage adverse environments. Harbors diphtheria toxins *transmitted by Regarded as extremophiles bacteriophage* ○ Alkaliphiles - high pH (low lvl of hydrog3n) ○ Halophiles - high salt concentration Horizontal Gene Transfer ○ Acidophile - low pH (high level of hydrogen Transduction concentration) - horizontal transfer mechanism where bacteriophage ○ Thermophile - high temperature transfer the virulence genes ○ Capnophiles - high level of carbon dioxide Conjugation There’s no disease causing Archaea - there is a direct cell-to-cell contact Prokaryote (Bacteria) - Mediated by an extracellular appendage, F pili (sex Cell wall is composed of peptidoglycan pili) which is used to transfer plasmid Nucleoid fold is the site of genetic material Bacterial Transformation Ribosomes are engaged in protein synthesis - plasmid can be acquired through bacterial (translation) *no cell can live without proteins, so all transformation *ung naacquire na plasmid ay naked living cells are capable of undergoing translation* plasmid or naked DNA* Ribosome is 70s Requirements of transformation Cell membrane is present 1. The bacteria which is the recipient of the naked DNA DNA double-stranded circular is a competent bacteria *competent when there’s a Plasmid is an extra chromosomal DNA present in the receptor sa surface na makakareceive ng naked cell dNA* Mode of reproduction: Binary fission 2. The acquired DNA is naked, not via MGE or pili Eukarya DNA is bound in a membrane eDNA Ribosomes are engaged in protein synthesis Environmental or extracellular DNA which are the (translation) *same as prokaryotes* DNAs that are released by a dead bacterial cell. *pag Ribosome is 80s nag lyse bacterial cell, eDNA is released Cell membrane is present (fragmented)* DNA double-stranded linear plentiful Mode of reproduction: Multiple fission and budding uses metagenomics Eukaryote known for budding: Yeast *known as embedded in EPS (Extracellular polymeric substance) unicellular fungi* *serves as a glue* of biofilm (inert surface) [e.g., of biofilms: river stones (madulas), catheter, tartar, Medical Microbiology 08/07/24 denture, and braces] Virulence Factors - Disease Inducing Factors in Microorganisms Enzymes Regarded as Virulence Factors Natural Virulence Factors Hyaluronidase - Inherent or intrinsically produced *means natural* Known as “spreading factor” Acquired Virulence Factors Breaks down the connective tissue protein called Transmitted by mobile genes elements (MGE) hyaluronic acid. Example of MGE: Many beauty products are impregnated with Includes plasmids (present in mostly gram negative hyaluronic acid. bacteria and some yeasts) Sources of hyaluronic acid: seaweed, chicken feet *double stranded circular extra chromosomal dna* *high in collagen* Insertion sequences or IS *Additional notes: Epithelial tissues are avascular (no blood Integrons - MGE in cassette; e.g., Pseudomonas vessels); found in outermost and innermost. They get their Aeruginosa nourishment from the connective tissue layer (highly vascularized).  Topics, *Additional Notes, Examples Ground substance ng connective tissue ay mayaman sa cause food poisoning hyaluronic acid. Causes pimples, acne, cellulitis, boils, furuncle, S. aureus will break the epithelial barrier and elaborate carbuncle (malaking pigsa), toxic shock syndrome hyaluronidase to break down the hyaluronic acid in the Virulence factors: protein A, microcapsule, plasma connective tissue* membrane, adhesins, invasins, toxins [produces S. aureus is coagulase positive hemolysin (breaks down red cells)] ○ alpha hemolysin: incomplete hemolysis = Streptococcus pyogenes blood agar: greenish Causes ○ beta hemolysin: complete = blood agar: Heart: rheumatic fever clear zone e.g., S. aureus Kidney: cause post-streptococcal glomerulonephritis ○ gamma hemolysin: none = blood agar: no Tonsillitis zone of inhibition Triad of diseases: tonsillitis, rheumatic fever and *sheep blood 5% for blood agar* post-streptococcal glomerulonephritis Methicillin-resistant Staphylococcus aureus (MRSA) Highly invasive cause of hyaluronidase - cannot be treated with normal antibiotic *recurrent tonsillitis requires Antistreptolysin (ASO) test* Streptococcus pyogenes Protease Virulence factors: protein M, capsule, adhesins, Substrate: protein invasins, exotoxins Gram positive: may lipoteichoic acid ang cell wall Coagulase Can be encapsulated an enzyme that will induce coagulation S. aureus is coagulase positive Cryptococcus neoformans Yeast Lipase Unicellular fungus common in clostridium *lipase-producing bacteria* Known to be an opportunistic fungal pathogen Substrate: lipids, e.g., triglycerides Causes fungal meningitis and Cryptococcosis Exhibits budding formation DNAse Cryptococcosis breaks down the DNA (substrate) Experiment: Avery Macleod and Maclyn McCarty; *Additional: CSF = cerebrospinal fluid and if turbid/hazy, may tried to find out the transforming factor which is the meningitis because a normal csm is pristine clear DNA because when the researchers put DNAse, the bacteria did not transform Salmonella typhi Gram negative; bacillus Bacterial Toxins Widal test: serological test for salmonella; typhoid Endotoxins fever Will only be released once the bacterial cell is lysed ○ uses O antigen and H antigen, paratyphi A Confined in the LPS and paratyphi B as antigens or reagents. Lipid A is found in the LPS *specific protein ean na ○ clinical presentation: on and off high grade associated with endotoxin* fever and diarrhea Gram negative bacteria ○ kind of febrile disease *Special cell wall kasi may outer membrane sela Peritrichous: flagella surrounds the cell hehe membrane* Serological testing Associated with innate immunity Bacterial agglutination test *anamnestic response is a characteristic of adaptive Titer: reciprocal of the highest serum dilution immunity* showing positive result Monocyte or macrophage in a connective tissue is Positive result: bacterial agglutination called a histiocytes If the reagent is antigen, detects antibody and vice When endotoxin is present in high amount, the versa patient may die of septic shock *septic shock means ○ O: somatic antigen **galing sa cell wall ng sudden drop of blood pressure* bacterial** Endotoxins are less antigenic since it induces ○ H: flagella antigen inflammation *best vaccines are proteins* ○ OH: both galing sa cell wall ng S. typhi 1/80 is the highest dilution showing positive result Exotoxins Titer: 80, which is the significant titer **u have a Highly antigenic typhoid fever na** Linked with adaptive immunity Released by living pathogens MedMicro 08/21/24 Extremely immunogenic because it’s basically Review of the Immune System protein Cells of the Immune System e.g., tetanus toxin produced by C. tetani, botulinum Originated from hematopoietic stem cells toxin caused by C. botulinum, anthrax toxin caused Myeloid progenitor: by B. anthracis **all gram positive** monocyte: becomes macrophage with pathogen Both gram positive and gram negative Lymphoid progenitor: Gram negative: E. coli, V. cholerae (comma bacilli), C. difficile causing pseudomembranous colitis Additional notes (not part of the immune system): In a whole (inflammation of the colon caused by antibiotics) blood: 55% plasma, the remaining are cellular components: white blood cells (for defense), platelets (hemostatic clogs Staphylococcus aureus regulate the plugging and prevent further bleeding) and Gram positive; cocci packed red blood cell (transportation and dissemination of Cell arrangement: grape-like cluster oxygen and nutrients throughout the body) Catalase positive *bula sa agua oxinada* Blood transfusion: whole blood or packed red blood Wound infection w/ nana and abscess cell  Topics, *Additional Notes, Examples Homeostasis - state of balance When partnered with antigen, neutrophils become Hemostasis - clotting mechanism which is associated phagocytic and becomes microphage with thrombocyte or platelets Monocyte Eosinophil No granules Characteristics of parasitism: payat, distended When confronted with antigen, it becomes tummy, di makatulog, and high number of eosinophil macrophages Characteristics: Bilobed RBC Staining reaction: eosin dye [acidophilic] Concavity that is the place where the nucleus used to Granules color: pink, red be located Asthma and parasitic infections No nucleus for larger surface area *add. notes: platelets are the smallest and the fragments of Hypersensitivity Types cytoplasmic granules and the largest wbc in the bone marrow, megakaryocytes* Macrophages Antigen presenting cells Antigen processing cells Medical Micro 08/30/24 Rouleaux formation - RBCs in a stack of coin formation - Normal Type I - simple allergic reaction associated with Neutrophils anaphylactic reaction eg., food allergy, pollen allergy - Most numerous WBC in the peripheral blood Antibody: IgE - In the presence of antigenic stimulation becomes Type II - antigen antibody reaction. Hemolytic type phagocytic microphage of reaction. eg. Blood transfusion, erythroblastosis fetalis Macrophage Antibody: IgG or IgM pero mas IgG - Largest WBC in the peripheral blood - monocyte *mother Rh negative and developed antibodies and sagot dito attacked the red cells of the child.* - Horseshoe shaped nucleus Type III - eg. Systemic lupus erythematosus (SLE), rheumatoid arthritis (not always autoimmune) Cells of Innate Immunity: Neutrophils, Macrophage, Dendritic Antibody: IgG, sometimes IgM Cells, Monocytes Type IV - delayed response or reaction. Cellular immune response. e.g., tuberculosis Lymphocytes *skin test for tuberculosis: Mantoux Tuberculin test* - WBC that have the most significant control in Antibody: T-cells immune response Types I-III are immediate and humoral mediated - Cells of adaptive immunity (B and T cells) - Most preferred/ best source of DNA for karyotyping Basophil - Has a relatively high nuclear-to-cytoplasm (NC) ratio Circulating in the blood *malaki nucleus, thus contains malaking Unusual to see more than 1 basophil per OIO chromosomes* Hypersensitivity and allergic reaction - Cytoplasmic ratio: a ratio of the size of the nucleus of Best remedy: antihistamine a cell to the size of the cytoplasm of that cell. Characteristics of basophil cells: - Ficoll-hypaque technique: separate the blood to its ○ the nucleus is bilobed components, specifically the lymphocytes. ○ granules color: blue, black - Phytohaemagglutinin (PHA) reagent: transforms the ○ entire cytoplasm is covered in basophilic lymphocytes into blast cells > you add a colchicine granules Reagent to halt the process > mag uundergo ngayon ○ granules is filled with a chemical mediator si lymphocyte ng mitosis and sa metaphase maarrest of anaphylactic reaction called histamines sya> add a lysine agent to release the chromosome> and heparins stain with Giemsa stain Wheal-flare reaction: urticaria (wheal or pantal), pruritus (itchiness), and redness (flare) **mediated CBC includes: by histamine kaya binibigyan ng anti-histamine** 1. RBC count - To know if the patient has anemia Mast Cells - ↓RBC indicates anemia Same characteristics with basophil - They both have granules (alkaliphiles) that covers the entire cell - both participate in type I hypersensitivity Tissue counterpart of basophil Anemia types Neutrophils Normochromic normocytic anemia: ↓RBC *sobrang Fine azurophilic granules in cytoplasm bagsak*; due to severe blood loss such as Granules have neutral staining reaction miscarriage Trilobed The first one to fight infection  Topics, *Additional Notes, Examples Megaloblastic anemia: caused by Diphyllobothrium - Inactivation of the complement: 56°C for 15-30 mins latum in a waterbath to destroy the complement as it interferes the reaction of the VDRL *In Hypersensitivity, Type 2 and 3 are complement mediated reactions* *People with Autoimmune diseases lack complement proteins because their complement is consumed* Rheumatoid arthritis - Autoimmune disease; attacks own antigen - Antigen: IgG or neoantigen Hypochromic microcytic anemia: RBCs are relatively - Antibody: IgM (Rheumatoid factor or Rf); Rf is an smaller than normal; RBCs are maliit and maputla; IgM produced in response to an altered IgG could be caused by a hookworm > to identify, - Nagkaroon ng infection sa synovial membrane, which tingnan kung mataas na ang eosinophil levels is attacked by bacteria; first response is si neutrophil; pag di kaya pupunta na si monocytes; while monocytes are doing phagocytosis, naglalabas sila ng nitric oxide and enzymes (protease) - Magkakaroon na ngayon ng humoral response, pupunta na si IgG sa site of infection; pero yung napakaraming enzymes na naproduce ng monocytes will destroy the IgG; pag nasira marerecognize sya ng 2. WBC count katawan mo as new antigen kasi altered ang - To know if the patient has an infection morphology ni IgG; gagawa ngayon ng bagong - ↑WBC indicates presence of infection antigen tas yun na si IgM 3. Differential Count - Together with Hematocrit and Hemoglobin levels Lysis/ Lytic reaction - dissolution; pagkatunaw; - Pam back-up sa RBC and WBC count complement-mediated immunologic reaction; participating components: antigen, antibody, and complement Antibody Structure Bacteriolysis - antigen is bacterial cell; Hemolysis - antigen is RBC Lysine - antibody Bacteriolysin Hemolysin Anti-D - Antibody; also called as anti-RH or RH factor - In Hemolytic Disease of Newborn (HDN)/ Erythroblastosis fetalis, si baby is may antigen D tas Fragment antigen binding (Fab): comprises the yung nanay nagka anti-D in her plasma; si anti-D of heavy chain and light chain variable; binding site for nanay pumasok via the placenta tas sa plasma ni the RBCs bearing the blood group antigen bebi may complementi; yung tatlo (antigen D ni bb, Fragment, crystallizable (FC) region: tail region or antibody ni mother, and complement ni bb) constant heavy chain; binding sites for effector cells; magdidikit n magkakaron ng hemolysis yung RBC ni also the binding site for the complement bb Light chain: either be kappa or lambda; plasma cells dictates Antibody Classification Heavy chain: dictates anong klaseng antibody ○ Gamma - IgG ○ Mu - IgM ○ Alpha - IgA ○ Epsilon - IgE ○ Delta - IgD *Humoral immunity is antibody mediated (B cells); Cell-mediated immunity is cell-mediated (T-cells)* Complement - Thermolabile protein; naturally present in the blood; completes the reaction or immune response Cholera - Vibrio cholerae: gram negative, monotrichous IgM Pentamer; most efficient agglutinating antibody - Rice watery stool because it has 10 Fab; hemagglutinin antibody; responsible for intravascular coagulation; Syphilis molecular weight: 900,000 daltons - Treponema pallidum - STI IgG can easily cross the placenta; monomer (2 Fab); - Spiral bacteria implicated in the hemolytic disease of the - Serological test: Venereal Disease Research newborn or Erythroblastosis fetalis; molecular Laboratory (VDRL) *kelangan ng complement sa weight: 150,000 daltons testing*; yung complement sa serum ni patient dat inactivated IgA Has two types: secretory and serum  Topics, *Additional Notes, Examples Secretory IgA: 4 Fab Site of swelling Indicates Serum IgA: 2 Fab (monomer) Back of the ears Weak lungs IgE Monomer (2 Fab) Kulani sa kili-kili Breast problems *A woman with a blood type O should also marry someone Singit Sexually transmitted with blood type O; since si O has anti-A and anti-B tapos yung diseases, e.g., HIV anak mo naging type A, B or AB; these antibodies can easily cross nga the placenta which will attack the RBCs of the baby, causing hemolytic disease, leading to anemia or jaundice MedMicro 09/06/24 (paninilaw)* Innate Immunity First line of defense Physiologic Jaundice Neutrophils followed by macrophages - Kapag nagka hemolytic disease diba the baby’s RBCs are lysed tas yung hemoglobin narerelease sa Opsonization bloodstream; mabe breakdown yan ngayon sa liver, Opsonin will tag the cells that will be phagocytize by spleen, and bone marrow into a heme; tas si heme the lysosome mabe breakdown into bilirubin diba dibaa? Process where the pathogen is targeted for - Phototherapy: bilad mo sa araw anak mo parang destruction by the macrophages danggit ba HAHAHAHAHA; pag nabilad (UV rays) kasi Increase the efficiency of phagocytosis na-phophotooxidize si bilirubin; inactivated pa Monocyte or macrophage in a connective tissue is vitamin D ng babies saur to activate the vitamin D is called a histiocytes *fixed macrophages* paarawan mo Opsonin: the one that codes for the pathogen *ito 1st activation of vitamin D ung tag na sinasabi ni ma’am irish. Good times T_T* - Skin Opsonin tags the pathogens 2nd activation of vitamin D Macrophage will phagocyte it by bringing it to - Liver and kidney lysosome to be destroyed - Pag active na si vitamin D pede na sya mag absorb ng After digested, antigen processing (digestion of calcium from the gatas na iniinom ng anak mo tapos pathogen) na tapos antigen presentation dadalhin sa bones (calcium deposition in the bone) (fragmented will be bounded to MHC II) tas titibay na anak mo MHC I is present in all nucleated cells *marker of - Kaya pagkatapos mo paarawan, painumin mo na ng self* gatas para hindi mapilay ganon tas pag napilay MHC III is for complemented proteins iscotch tape mo lang oki na yan Interleukin daw IgM muna tapos IgG pag may memory na In deep sleep IgG: secondary immune response - Naglalabas ng growth hormones si anterior pituitary Most abundant and anamnestic response ang IgG gland kasi forever daw nandyan na *hala si dean - So dat diretso tulog para tumangkad anak mo bumabanat* Only the processed antigen will bind on the FAB site How does an agglutination reaction become a defense *processed antigen: fragmented coupled with MHC mechanism? class II* Rules Binding site of macrophage ang FC region - Kung ano blood type mo, yun ang antigen mo The surface of the cell is negatively charged, so - Kabaliktaran ng antigen mo yun ang antibody mo there’s electrostatic repulsion. - e.g., your blood type is A, then your antigen is also A Through opsonization, repulsion would be minimized but your antibody is B because of the presence of receptors - When blood type B na may B antigens on the surface ng RBCs, is transfused into a patient with blood type Efficiency of Phagocytosis A, the anti-B IgM antibodies ng pasyente is Easily identifiable targets because of tagging magbibind sa B antigens ng transfused blood; kapag Presence of receptors nag bind nag cross-linking and clumping; tapos pentamer pa si IgM kaya mabilis magcross-link kaya Two types of Opsonin sya culprit pag namatay si patient sa intravascular Antibody mediated coagulation Antibodies tags and serves as the opsonin (IgM or IgG) Antibodies that have J-chain Complement mediated - IgM Complement proteins *native to the body* - Secretory IgA: found in the colostrum VDRL *destroys the complement or inactivate* Bone marrow Tagging of Misfolded Proteins - B and T-cell production Once translation finished, proteins must be folded - B-cell maturation correctly Misfolded proteins will be tagged by ubiquitin Thymus The misfolded proteins with ubiquitin will be brought - T-cell maturation to a cell organelle called proteasome - Grows rapidly Lymph nodes MedMicro 10/07/24 - Becomes swollen if there’s an inflammatory reaction (battlefield of adaptive immune response) Staphylococcus aureus - Site of inflammation indicates the infection Streptococcus pyogenes  Topics, *Additional Notes, Examples Both beta hemolytic bacteria - myositis: inflammation of the muscle - Necrotizing Fasciitis Lancefield Classification of Streptococcus - Sepsis or septicemia - Impetigo: skin infection where there is yellow crust on the skin Blood Agar/Hemolysis Test (Streptococcus) Blood agar contains 5% sheep blood It tests bacteria’s ability to lyse RBC (erythrocytes) Lysis of erythrocytes is called hemolysis and is catalyzed by enzymes called hemolysins Based on bacterial typing Hemolytic Patterns Same as blood typing, but uses bacterial antigen and Alpha hemolytic (e.g., Viridans streptococci and reacts with homologous antibodies to identify the Streptococcus pneumoniae) serotype. Optochin Test (Antibiotic) Most important groups: A and B Optochin resistance: viridans; non-encapsulated; no Group A: Streptococcus pyogenes ZOI Group B: S. agalactiae (b-hemolytic strep) Optochin sensitive: S. pneumoniae; encapsulated; Group C: mostly zoonotic *nice to know lang daw* clear/wide zone Group D: Enterococcus faecalis, E. faecium *part of Nuefeld Quellung Test (Capsular Swelling Test) the flora of our large intestine* Test for encapsulated bacteria ○ Gram positive cocci in the large bowel (+) result: swelling of the capsule Enterococcus spp. Bile Solubility ○ Enterobacter aerogenes S. pneumoniae hydrolyzes bile; Viridian does not Gram negative bacilli under the family Enterobacteriaceae Group B Lancefield Class ○ Lactose fermenters: E. aerogenes, K. GAH Group A beta hemolytic Streptococcus - eg. pneumoniae and E. coli Streptococcus pyogenes Group M&O: Streptococcus mitis - found in the oral Group B beta hemolytic Streptococcus cavity S. agalactiae - agent of mastitis in ruminants Group N: Lactococcus lactis - lactic acid bacteria Mastitis - inflammation of the udder (mammary Group R&S: Streptococcus suis - swine gland of the female ruminants) Group A Streptococcus CAMP TEST Facultative anaerobe Christie-Atkins-Munch-Peterson Gram negative; cocci in chain Test to identify Group B-hemolytic streptococci Catalase and coagulase negative (Streptococcus agalactiae) Formation of substance (CAMP factor) that enlarges Virulence Factors of S. pyogenes are of hemolysis formed by B-hemolysin elaborated Virulence Protein - M protein - antiphagocytic *will from S. aureus. release M protein which allows S. pyogenes to cover Uses blood agar; streak S. aureus vertically to act as itself (counters opsonization) and avoid control; unknown is streaked horizontally phagocytosis* Arrowhead zone of hemolysis (point of Other Virulence Factors: contact/juncture): positive of S. agalactiae - Hyaluronidase (spreading factor) Combination of both means enhanced inhibition - Streptodornase: liquify the pus since both are b-hemolytic strep - Streptokinase: liquify the clot - Streptolysin O and Streptolysin S - b-hemolytic Group D Lancefield Class **Strep O is more antigenic; uses ASO test** Enterococcus faecium or E. faecalis Erythrogenic (reddening of skin)/Pyrogenic (fever) Commensals of intestine toxin - carried by bacteriophage Bile Esculin Hydrolysis Test: differentiates ○ Cardinal Features of Scarlet Fever Enterococci from other group Streptococci - Erythro: reddening Uses Bile Esculin Agar: differential and selective - Pyro: fever medium Pyo means pus producing (e.g., S. aureus) Bile - inhibits growth of gram positive except for Pyro means fever producing (e.g., S. pyogenes) Enterococci Exotoxin of S. pyogenes Sodium Azide - inhibit growth of gram negative Toxic shock syndrome (TSS)Scarlet Fever (erythrogenic toxin) Bile Esculin Test: ○ Fem who uses tampons; hypotension (shock) 1. Inoculate Scarlet Fever (erythrogenic toxin) 2. Slant of the BE medium with S-shaped motion ○ Strawberry-like tongue; generalized rashes; 3. Incubate 35-37C; 24hrs high-grade fever; pharyngitis ○ DICK TEST: skin susceptibility test for Scarlet Fever Alpha-Hemolytic ○ SCHICK TEST: susceptibility test for S. pneumoniae Corynebacterium diphtheriae Viridans Other diseases: Gamma-Hemolytic - Pharyngitis/Tonsillitis Mouth: Streptococcus mutans (dental plaque; tooth - rheumatic fever cavity) same as S. mitis - Post streptococcal glomerulonephritis S. mutans: greenish zone of inhibition  Topics, *Additional Notes, Examples Otitis media Hemophilus spp. Blood-loving bacteria They require growth factors (cannot be grown in ordinary growth media Factor x: when blood lyses, x factor will be released V factor: more on NAD+ (coenzyme) ○ Provided by S. aureus (b-hemolytic). When cell lyzed, the cofactor will be released. ○ Satellite Phenomenon: the H. influenzae surrounds the colony of S. aureus Species Required Factor: H. influenzae X and V factors Wrongly Identified to be the cause of flu; flu is caused by a virus; major cause of meningitis in the ruminants H. ducreyi X factor Causes soft (chancre) chancre; *hard chancre is caused by Treponema pallidum* H. aphorphilus X factor Not medically (Aggregatibacter important aphrophilus) H. aegyptius X factor Bacterial agent of (conjunctivitis) sore eyes; pus = bacterial, no pus = viral ( H. V factor - parahemolyticus H. parainfluezae V factor - H. X factor - hemoglobinophilu s Important: If it starts with “Para” it requires V factor; if not, X factor; the only X and V is H. influenzae Diseases Associated Typeable R Meningitis Septicemia epiglottis Non-Typeable Hemophilus spp. Pneumonia Bronchitis Endocarditis